Organization
PROVIDENCE HOME HEALTHCARE COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROLANDO GUTIERREZ (OWNER)
(704) 827-0037
Entity
Organization
Contact information
Practice address
530 E CENTRAL AVE, MOUNT HOLLY, NC 28120-2117
(704) 827-0037
(877) 582-3818
Mailing address
530 E CENTRAL AVE, MOUNT HOLLY, NC 28120-2117
(704) 827-0037
(877) 582-3818
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
HC3882
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HC3882
—
NC
Enumeration date
09/10/2009
Last updated
09/10/2009
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